This invention relates generally to the generation of nitric oxide in situ and to nitric oxide sensors, and more particularly to biocompatible materials having surfaces that are capable of generation of nitric oxide in situ when contacted with nitrite, nitrate or nitrosothiols in blood, and to a reproducible nitric oxide sensor.
Although medical devices such as extracorporeal circuits and hemodialysis tubes are widely used in clinical settings, the polymers typically used to fabricate such devices (PVC, polyurethane, silicone rubber, etc.) are still subject to platelet aggregation and adhesion onto the surface of these materials. Thus, patients are often given anti-clotting agents (i.e., heparin) in order to reduce thrombosis on the surface of these devices. Similarly, implanted devices made of stainless steel or other alloys, or even carbon, can cause thrombus formation when in direct contact with blood. There is, therefore, a need for materials that more closely simulate the antithrombogenic properties of the endothelial cells that line blood vessels in order to obviate the need to administer anticoagulants.
Nitric oxide (NO) is an important intracellular and intercellular messenger molecule that plays an important physiological role in anti-platelet aggregation and anti-platelet activation, vascular relaxation, neurotransmission, and immune response. It has been proposed that synthetic materials that release low levels of NO would, therefore, more closely simulate the natural activity of endothelial cells, and therefore, would have improved biocompatibility.
Several classes of NO-releasing materials are currently under investigation worldwide. These include NO donors (i.e., diazeniumdiolates, nitrosothiols) that may be relatively complicated to synthesize and may in some instances require stringent storage conditions.
Currently, NO generation is determined by water uptake (such as in the case of diazeniumdiolates) or the intensity of light (as with iron nitrosyls). However, blood already contains a host of species that are derived from, or are physiologically-generated in vivo that may be reduced to NO. These species include nitrites, nitrates, and a host of nitrosothiols (e.g. nitrosoglutathione, nitroso albumin, etc.). The presence of these species raises the possibility of recycling these species back to nitric oxide.
S-nitrosothiols (RSNO) are believed to take part in the storage and transportation of NO in biological systems. While RSNOs are generally stable in physiological conditions, they may, in some instances, be sensitive to photolytic breakdown and catalytic decomposition in the presence of transition metals to produce the free thiol and NO. Modification of the membrane design of NO sensors may be used to fabricate a nitrosothiol sensor and thus detect the presence of nitrosothiols in fluids.